Mum-of two Sally opens up about the emotional health difficulties her adopted children have.

Sally Donovan opens up about the health issues experienced by her two adopted children and the support they receive.

Sally and Rob Donovan decided they wanted to start a family in their early thirties. But after years of trying, they were told that they couldn't conceive naturally, a fact which took a long time for them to get used to.

"Infertility is horrible, and the effects of it are underestimated by those who haven't experienced it," says Sally, now 45. At first the couple felt very isolated, but they were able to turn to each other for support. "We dealt with it together by talking and giving each other space when we needed it."

In time, Sally and Rob began to explore IVF, surrogacy and adoption. The nurse at Sally's GP surgery put them in touch with parents who had adopted and other parents who conceived through IVF, so they could ask questions. After much reflecting, they chose to adopt, as Sally explains:

"It wasn't important for us to have children who were genetically connected to us, and I wasn't sure that I wanted a lot of medical intervention in order to conceive. As there are many children in care who can benefit from being part of a stable and loving family, it felt like the obvious choice."

After being approved as adopters, Sally and Rob were thrilled to be matched with a sibling group: their son Jamie, then four years old, and daughter Rose, then aged one.

Adopted children with complex emotional needs

Like many children who are taken into care, Jamie and Rose's early traumatic experiences of neglect and abuse have led to ongoing difficulties around their emotional development and health.

"Learning to be the parents that our children need has been both rewarding and extremely challenging," says Sally.

Anxiety as a result of traumatic experiences

The children spent their early months and years in a state of fear and isolation, and had to develop survival skills that equipped them well at that time. Although now in a safe environment with Sally and Rob, Jamie and Rose have high levels of anxiety and are on high alert for potential danger, even though they no longer need to be. This can make life at school particularly challenging, as sitting still to focus on something can make them feel under threat.

Issues around food due to neglect

Long periods of neglect – including being deprived of food – before they were taken into care, left both children with deep and long-lasting issues around food. They constantly need Sally and Rob to reassure them that they will always have plenty of food in their lives.

Learning difficulties resulting from neglect

Jamie and Rose also have a range of cognitive difficulties, which can include problems with learning, understanding and remembering things. Sally believes the reasons for this are due to their early brain development being interrupted by high levels of fear, and a lack of nurture. At times they display feelings of anger, which Sally feels is a delayed reaction to their early trauma. "It's a release of fear and sadness which has been held in," she says.

Access to post-adoption support

In the early years after the adoption, Sally felt the support the family received, from social services, health services and their GP, was generally poor. For example, she feels the children would have benefited from much better speech therapy early on, "before they experienced difficulties talking to other children at school".

Some support eventually came from a social worker who started a clinic carrying out therapeutic family therapy, based at the Child and Adolescent Mental Health Service (CAMHS). "It was fantastic, and has been instrumental in shaping our children's progress," says Sally, who wants more NHS support for children who have experienced developmental trauma.

"Children like ours deserve treatment, just like anyone else with any other health need. Effective treatment can significantly improve a child's chances of achieving a happy family, social life, an education and future career."

Fortunately, the family's support network has improved in recent years. The post-adoption support team within Sally's local authority are more experienced at supporting adoptive families. "Although they currently have no budget to cover therapeutic services, they provide advice and training on therapeutic parenting, will go into the children's school to give advice, and are there to listen when we need them," says Sally.

Finding the right school for children who have been in care

"School is often the part of life that adoptive children struggle with the most and if it isn't going well it can risk having dire consequences for family life," says Sally. "So it is important to get it right."

Her advice to other adopters is to visit as many schools as possible and ask specific questions. "Ask questions of relevant staff around trauma and attachment issues and see if they have any knowledge or feel for them. Particularly test for empathy and compassion if you can and a readiness to learn, with you, about what works and what doesn't."

Sally also highlights concerns around how a school disciplines children who have been in care. "I would also be enquiring about what behaviour system a school uses. If it is very strict and involves shame [by deliberately drawing attention to the child in a negative way] then I would be very careful.

"Our children learn and are calm when they feel safe and liked." Sally points out that it is common for adopted children to have low self-esteem. "Branding them as 'naughty' plays into the hands of the narrative they have of themselves ('I am bad')," she says.

Sally and Rob's own mental health and wellbeing

Any parent can relate to the emotional highs and lows involved in bringing up children. But children who have been traumatised, as many adopted children have, can behave in a much more challenging way. For their parents, this can be hard to cope with and to explain.

Despite support from friends and family, Sally feels there is a lack of awareness about the impact upon a child of early neglect and abuse.

"There was a time when it felt as though there was very little support available, and that few people around us, including professionals, understood what we were experiencing," she says.

"We read what we could about therapeutic parenting methods but it was only when our new support worker came into post that things improved. She helped us to find a more appropriate school that not only supported our children much more effectively, but us too. She also allowed us to share our feelings and frustrations and hopes and fears with honesty. This alone made a big difference."

In addition, Rob experienced a bereavement just after the children were placed with them, when somebody close to him died. To try and cope, his grief was "put on hold", but returned later on when life had settled down. "He didn't seek any medical help and I believe he should have," recalls Sally, who saw signs of depression developing in her husband. "But he is much better now."

Sally and Rob agree that the most rewarding part of their adoption journey has been seeing their children develop in confidence and emotional resilience. "Adoption isn't the easy route to raising a family, but it forces you to see the world through your child's eyes and to learn new ways of parenting," says Sally. "It makes you consider much more carefully both what is achievable and what is important in life.

"Our children have taught us so much and we are better people for having been their parents."